Been refused homebirth due to high blood pressure - anyone else been through this?

[BefnalBub]

My GP has just told me my blood pressure is too high (its not pre-eclampsia) and put me on medication. She said it wouldn't be sensible to go for a homebirth and that pushing is dangerous for high blood pressure (does that mean they'll give me a certain amount of time to push before a c-section is enforced?). Not happy at all - would love to know if you've experience of this.

Controlled or valsalva type pushing is bad for your blood pressure(the kind where they say hold-your-breath-put-your-chin-on-your-chest-and-now PUSHHHHHH 1,2,3,4,etc" - do they still even do that here??). Non-breath holding type pushing where you just push with the urge and don't force it, is not. If your caregivers will allow passive descent, that is basically waiting until baby has come down the birth canal and is practically crowning before pushing begins, so much the better. How high is your BP do you know? It's normal for BP to be elevated in pregnancy, what matters is how high it is compared to your normal baseline. Is the decision on whether or not to have a homebirth up to your GP - do you have a midwife as well? Or could you at least get a second opinion?

Your GP does not have the authority on where you give birth - you decide where you want to give birth, in consultation with your midwife (and consultant if you have one).

Your GP is not an expert in obstetrics - many GPs are still under the mistaken impression that they have to attend homebirths from their practices, and try to put people off because of it. Discuss the issue with the midwives - they are the experts - if they think you need to speak to a consultant, then they will refer you.

Of course you can birth where YOU want too, you could ask on this midwifery group they will be able to give you some good advice.

thank you for your responses - I'll check the group as well. my baseline was 90/58 and its pretty much gone up every check since then and is now at 150/92.

First of all, it is not normal for blood pressure to be raised during pregnancy; if anything it should be at a lower level than when not pregnant.

Second, GPs deal with raised BP all the time, not just pregnancy induced high BP. If Befnalbub's pressure is high enough to be put on medication then it must be fairly high surely.

Anyway, BB, I developed moderate/severe BP levels immediately post-birth (it was completely fine throughout the pregnancy).

If I were you I'd get a second opinion, preferably from a consultant tbh. High BP must be taken seriously.

Good luck . I'd be interested to know how you get on!

Didn't see your post when I was writing mine, sorry!

150/92 is high even for a non pregnant person.

I had a home birth, with an independent mw after some high blood pressure readings (as high as 140/105, one of them) but I used to get very stressed at the sight of a white coat. I had a couple of 24 hour blood pressure monitors and they found that it was perfectly normal when I was at home, and I stopped a high-stress job as early as I could. It was also fine in labour (but I felt really calm at home with a midwife I knew).

You might be better off getting the 24h monitoring done if you think it might be white coat syndrome or perhaps agreeing a birth plan you're happy with if you're more worried about interventions you don't want. Nobody can enforce a section without your consent. You could also consider hiring a doula if you want someone to speak up for your wishes in a hospital setting. I got the impression that a home birth is a relatively high risk choice if your blood pressure really is high, so you should look into it carefully.

homebrth site.

YOur blood pressure does sound very high and I would not personally want a homebirth with that kind of risk factor. Why not discuss the options with your midwife? A birthing centre attached to a hospital could be a good option.

Mercy you are quite right that BP can often drop mid pregnancy, sorry. I agree that high BP can be a possible cause for concern, and did not intend to suggest the GP did not know what they were talking about. It's just that high BP alone need not rule out homebirth and it seemed as if the GP was implying this.

By the way there is some evidence that a diet high in protein can help with high blood pressure in pregnancy so you might want to review your diet - take a look at the blueribbon baby website #link{http://www.blueribbonbaby.org/index.html#here}. Also strangely you might find you are a bit low on salt - are you salting your food to taste? Relaxation and gentle exercise can also help - yoga, swimming.

I was in your situation BB, normal BP pre-pregnancy but it went up throughout, even though it wasn't pre-eclampsia. It was a bit of a mystery as pregnancy-induced hypertension normally only manifests after about 20 weeks.

Anyway I initially wanted a homebirth but after I was put on bp meds the midwifes advised me that hospital policy was that they would not give a home birth to anyone on bp medication as high bp puts you and the baby at higher risk of a lot of complications and it is therefore better to be close to all facilities. I was disappointed but felt their reasons were valid.

If I were you I would talk to your midwife (not your GP who is not an expert) and if necessary ask for a consultant's second opinion. Ultimately only you can decide where you give birth but you should make sure you make an informed choice.

oh and fwiw I had a vaginal delivery without epidural and my BP went down afterwards within hours.

I also had a number of other complicating factors on top of the BP that would normally 'rule out' a home birth (possible placental problems, possible problems with baby). My MW and I did agree though that if my BP was high during labour, then I would go in as we both felt the risks were too high in that case.

BTW, a Birth Centre might not be an option. I was told I couldn't go into the local one, despite the fact the delivery suite was next door and a transfer would have been simple. It would have been my first choice over home birth as they wouldn't take anyone high risk who 'might spoil their statistics' - you might encounter this

I read up very carefully and made the final decision at the last minute (36 weeks) when a lot of the problems they foretold would have already become apparent if they were going to. I also felt that a home birth was lower risk than for many as I live 5 mins from a teaching hospital. It was a very positive experience and it enabled me to take control back when my pregnancy had been so medicalised. I do feel that it's important to weigh everything up carefully and individually, and that home birth can be the right choice even in 'high risk' cases - it's very easy to get classified as 'high risk'.

However, all this didn't stop me having a PPH (not one of the risks they predicted!) and spending the following 5 days in hospital

chk out the link that lulu gave.

good luck with it.

cx

Agree with MissGolightly.
Was on low dose Methyldopa from middle of both my pg's due to raised blood pressure (150/90 was my worst!) Do not get this prob whgen not pg.
Felt fine throughout both pgs and didn't have any 'symptoms' such as swelling, nor signs of pre-eclampsia such as protein in urine, as consultant said I was 'borderline' and the medication kept it within acceptable limits.
Was induced (pessary) in hospital both times but put my foot down and refused further intervention (drip, epidural etc). Had vaginal delivery both times. Didn't even need gas and air with DD last year!
HTH and good luck

Have checked out the links & taken heart by the stories and sensible advice here. Thank you so much - really helps to know i'm not the only one and that there can be good, non-interventionalist outcomes in hospital and equally that it is possible to have a safe home birth if its carefully monitored. Feel a bit more in control now - it was just such a horrid shock at 36 weeks - wasn't expecting to have my plans changed!

Good luck with whatever you decide - I really sympathise as I was very sad to let go of the birth that I had wanted, and heart-sick at being on medication (and induced) when I had expected to be having a normal pregnancy. I went into the hospital feeling really blue and as if I'd failed my baby.

But you know what? It was fine, despite being in hospital I had a "good" birth, and as soon as my son was born I was soooooooo wrapped up in him that I couldn't have cared less how he got there.

Hi Befnal

I had the same shock with BP at about 36 weeks and never got the natural birth I planned, but I was in good hands and monitored constantly, had cesarean twice threatened, but managed to have vaginal birth.

To my knowledge eclampsia and BP is the biggest cause of death in the un-developed world, So I actually felt lucky in the end that I could have access to medication and a hospital.

I echo Miss Golighty says, it doesn't matter how they get there in the end, as long as they are well and you are too. Birth is a small part of having children in my opinion

I think you are right - healthy babies and mothers are the most important thing at the end of the day. As you say, just unhappy to get so far and then have a set-back like this! The tablets they've given me are adalat la 30 and appear to be contra-indicated during pregnancy - MG is that the same as they gave you? I'm a bit nervous about taking them .

Yep - doc looked it up and said it was safe. Just doesn't feel right! Am off to chemists to get BP remeasured - if its lower I may put off taking them for a couple of days!